Ptosis: In a normal person, the upper eyelid is located above the pupil of the eye when the eye is open, covering about 2 mm of the upper edge of the cornea. However, some people can only open their eyes a narrow slit, and their eyelids do not lift up, covering a portion of the cornea (more than 2 mm), which is medically known as ptosis. In order to get rid of the visual masking of the ptosis, patients often use frontal muscle contraction or head lifting posture to increase the visual field, which can cause deepening of the frontal wrinkles for a long time and can also affect vision and cause amblyopia, causing psychological and physical stress to the patient, which must be corrected through surgery.
Typology: congenital and acquired
Congenital is caused by a malfunction of the levator muscle that lifts the upper eyelid.
Acquired cases are mainly caused by trauma to the eye.
Surgical methods.
(1) Tendon folding
(2) frontalis flap suspension
Pre-operative preparation.
1.Before surgery, two preoperative examinations of routine blood and routine four items (routine HBVAg, HCVAb, HIV, TP examination) are required.
2, such as taking aspirin, Warfarin and other anticoagulant drugs, should stop 2 weeks before surgery.
3.Women need to avoid menstruation.
4.If there is any infection in the skin of the eye, it should be treated first before surgery.
5. Careful physical examination should be performed before surgery to select a suitable surgical plan based on the degree of ptosis, upper eyelid lift function and the presence of myasthenia gravis.
Post-operative precautions.
1. Postoperative care.
(1) Immediately after surgery, continuous hand pressure is applied to the eye surgery area. Gauze does not need to be changed frequently, and postoperative pressure needs to be applied in the hospital for 1 hour before going home, and pressure is applied as soon as you are free on the road, and pressure continues for 3 hours after going home.
(2) After the end of compression you can start cold compress for half a day: apply a layer of gentamycin eye ointment on the incision surface, or wrap a layer of plastic bag outside the ice bag, use an ice bag close to 0°, not too cold to prevent frostbite, 3-5 times, 10 minutes each time. Just keep the incision clean after the cold compress is finished.
(3) After 84 hours (about three or four days after surgery), start to apply hot compress, 3-5 times a day, 10 minutes each time, after 5 days you can open and close your eyes more.
2, the affected area within a week after surgery waterproof, three days to avoid eye fatigue (such as prolonged use of computers, look at the cell phone, etc.)
3, light diet for 3 months, avoid smoking and alcohol, spicy, seafood diet.
4, oral medication please take as directed.
5.Keep the incision clean and dry, start cleaning the day after surgery, 3 times a day, steps.
(1) Put boric acid ear drops on a cotton swab and use the swab to clean the blood on the incision surface
(2) Apply a thin layer of aureomycin ointment on the wound surface.
6.It is better to put the pillow higher when sleeping and resting in bed so as not to aggravate the swelling of the wound by the low position of the head.
After surgery, avoid external impact on the eyes, intense exercise, and strong breath-holding, which may cause bleeding and hematoma.
Some patients with ptosis cannot close their eyes tightly for a few weeks after surgery, so eye drops and eye ointment should be applied to prevent dry eyes.
9. If the wound is bleeding heavily, please follow up immediately or contact your primary surgeon.
10.The stitches will be removed 6-8 days after surgery, and the wound can be wetted 24 hours after the stitches are removed.
11.If there is a node left after surgery, or if the sutures in the wound appear to be rejection and exposed, you need to visit the doctor to remove them at any time.
12.Revisit at 2 weeks, 1 month, 3 months, 6 months, and follow up for discomfort.
Note: Boric acid ear drops should not be used for ear or eye drops, but only for wound cleaning.
Anti-scar treatment
1. Avoid mouth for 3 months and use less eyes.
2.Heat compress
3.Medication: De-inflammatory pine urea ointment (tretinoin urea ointment)
Usage: Start using it 1 week after stitch removal, take a small amount and apply it to the wound, do not rub it hard, otherwise the wound will become red and black.
4. Makeup should be applied to the eye only after 3 months.